Form CERT-106 "Claim for Refund of Use Tax Paid on Motor Vehicle Purchased From Other Than a Motor Vehicle Dealer" - Connecticut

What Is Form CERT-106?

This is a legal form that was released by the Connecticut Department of Revenue Services - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2016;
  • The latest edition provided by the Connecticut Department of Revenue Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form CERT-106 by clicking the link below or browse more documents and templates provided by the Connecticut Department of Revenue Services.

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Download Form CERT-106 "Claim for Refund of Use Tax Paid on Motor Vehicle Purchased From Other Than a Motor Vehicle Dealer" - Connecticut

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Department of Revenue Services
CERT-106
State of Connecticut
Public Services Unit
450 Columbus Blvd Ste 1
Hartford CT 06103-1837
(Rev. 11/16)
Claim for Refund of Use Tax Paid on Motor Vehicle
Purchased from Other than a Motor Vehicle Dealer
Part I - Instructions
To Submit a Claim: Submit CERT-106 and the documentation
described below within three years of paying the tax to:
Statutory Authority: Conn. Gen. Stat. §12-431(b)
Department of Revenue Services
General Purpose: A person purchasing a motor vehicle from a
Public Services Unit
person other than a motor vehicle dealer or licensed motor vehicle
450 Columbus Blvd Ste 1
lessor must pay Connecticut use tax on the average trade-in value
Hartford CT 06103-1837
of the vehicle as shown in the N.A.D.A. Offi cial Used Car Guide,
Supporting Documentation: All claims for refund must include the
Eastern Edition for the month of purchase. The average trade-in
following information. If you do not provide the documentation, DRS
value does not include additions or deductions such as for low or
cannot process your refund request.
high mileage or for optional equipment or the absence of optional
equipment. If the purchaser can prove the actual purchase price
Purchaser’s Declaration: The purchaser or purchasers must
of the motor vehicle was less than the average trade-in value and
complete the Purchaser’s Declaration on the back of this form.
submits a properly completed CERT-106 and the documentation
Indicate if the motor vehicle was purchased by more than one
described below within three years of paying the tax to the
person by checking the appropriate box in Part IV as to whether
Connecticut Department of Motor Vehicles (DMV), the Department of
the vehicle is owned in common or jointly.
Revenue Services (DRS) will refund the overpayment of Connecticut
Seller’s Declaration: The seller or sellers must complete the
use tax. Do not use CERT-106 if the actual purchase price of the
Seller’s Declaration on the back of this form.
vehicle equals or exceeds its average trade-in value. You owe
Sales receipt: Attach a copy of the sales receipt showing the
Connecticut use tax on the actual purchase price of the vehicle.
amount of sales tax paid.
Who Should Use This Form: Any person who:
Cancelled Check or Other Evidence of Payment of the
Purchased a motor vehicle from a person who is not a motor
Purchase Price of the Motor Vehicle: If payment was made
vehicle dealer or licensed motor
vehicle lessor; and
by check, attach a copy of the cancelled check issued to the
seller of the vehicle (front and back). Do not include a copy of
Paid less for the motor vehicle than its average trade-in value,
the check issued to DMV for payment of sales tax. If payment
as shown in the N.A.D.A. Offi cial Used Car Guide, Eastern
was not made by check, attach other evidence of payment such
Edition for the month of purchase; and
as a copy of the bank statement showing the withdrawal if you
Paid Connecticut use tax, when registering the vehicle with
paid with cash.
DMV, based on the vehicle’s average trade-in value; and
Explanation for Actual Purchase Price Being Less Than
Claims a partial refund of Connecticut use tax because the
N.A.D.A. Average Trade-In Value: Attach an explanation, and
person can prove the actual purchase price of the motor vehicle
documenting evidence such as a dated photograph from the
was less than the vehicle’s average trade-in value; or
time the motor vehicle was acquired, repair bill, and/or appraisal
of the condition of the vehicle.
Claims a full refund of the Connecticut use tax because the
person can prove the original purchase was exempt.
You must complete CERT-106 in its entirety and submit the
supporting documentation listed above. Submit clear, legible
The general sales and use tax rate is 6.35%.
copies of the original documents only. DRS will not return original
The tax on the sale of most motor vehicles for more than $50,000
documents.
is 7.75%. A
motor vehicle subject to this tax rate does not include:
Notice of Allowance or Disallowance of a Claim: DRS generally
A motor vehicle subject to the 4.5% tax rate for vehicles
gives notice that a claim for refund was allowed or disallowed within
purchased by members of the armed forces on full-time active
90 days of receiving a properly completed CERT-106. Allowed claims
duty who are not residents of Connecticut or their spouses;
are subject to further examination as provided by law.
A motor vehicle having a gross vehicle weight rating of 12,500
For More Information: Call 1-800-382-9463 (Connecticut calls
pounds or less that is not used for private passenger purposes,
outside the Greater Hartford calling area only) or 860-297-5962 (from
but is designed or used to transport merchandise, freight or
anywhere). TTY, TDD, and Text Telephone users only may transmit
persons in connection with any business enterprise and issued
inquiries anytime by calling 860-297-4911. Visit the DRS website at
a commercial registration or more specifi c type of registration
www.ct.gov/DRS to preview and download forms and publications.
by DMV; or
A motor vehicle having a gross vehicle weight rating over 12,500
pounds.
Department of Revenue Services
CERT-106
State of Connecticut
Public Services Unit
450 Columbus Blvd Ste 1
Hartford CT 06103-1837
(Rev. 11/16)
Claim for Refund of Use Tax Paid on Motor Vehicle
Purchased from Other than a Motor Vehicle Dealer
Part I - Instructions
To Submit a Claim: Submit CERT-106 and the documentation
described below within three years of paying the tax to:
Statutory Authority: Conn. Gen. Stat. §12-431(b)
Department of Revenue Services
General Purpose: A person purchasing a motor vehicle from a
Public Services Unit
person other than a motor vehicle dealer or licensed motor vehicle
450 Columbus Blvd Ste 1
lessor must pay Connecticut use tax on the average trade-in value
Hartford CT 06103-1837
of the vehicle as shown in the N.A.D.A. Offi cial Used Car Guide,
Supporting Documentation: All claims for refund must include the
Eastern Edition for the month of purchase. The average trade-in
following information. If you do not provide the documentation, DRS
value does not include additions or deductions such as for low or
cannot process your refund request.
high mileage or for optional equipment or the absence of optional
equipment. If the purchaser can prove the actual purchase price
Purchaser’s Declaration: The purchaser or purchasers must
of the motor vehicle was less than the average trade-in value and
complete the Purchaser’s Declaration on the back of this form.
submits a properly completed CERT-106 and the documentation
Indicate if the motor vehicle was purchased by more than one
described below within three years of paying the tax to the
person by checking the appropriate box in Part IV as to whether
Connecticut Department of Motor Vehicles (DMV), the Department of
the vehicle is owned in common or jointly.
Revenue Services (DRS) will refund the overpayment of Connecticut
Seller’s Declaration: The seller or sellers must complete the
use tax. Do not use CERT-106 if the actual purchase price of the
Seller’s Declaration on the back of this form.
vehicle equals or exceeds its average trade-in value. You owe
Sales receipt: Attach a copy of the sales receipt showing the
Connecticut use tax on the actual purchase price of the vehicle.
amount of sales tax paid.
Who Should Use This Form: Any person who:
Cancelled Check or Other Evidence of Payment of the
Purchased a motor vehicle from a person who is not a motor
Purchase Price of the Motor Vehicle: If payment was made
vehicle dealer or licensed motor
vehicle lessor; and
by check, attach a copy of the cancelled check issued to the
seller of the vehicle (front and back). Do not include a copy of
Paid less for the motor vehicle than its average trade-in value,
the check issued to DMV for payment of sales tax. If payment
as shown in the N.A.D.A. Offi cial Used Car Guide, Eastern
was not made by check, attach other evidence of payment such
Edition for the month of purchase; and
as a copy of the bank statement showing the withdrawal if you
Paid Connecticut use tax, when registering the vehicle with
paid with cash.
DMV, based on the vehicle’s average trade-in value; and
Explanation for Actual Purchase Price Being Less Than
Claims a partial refund of Connecticut use tax because the
N.A.D.A. Average Trade-In Value: Attach an explanation, and
person can prove the actual purchase price of the motor vehicle
documenting evidence such as a dated photograph from the
was less than the vehicle’s average trade-in value; or
time the motor vehicle was acquired, repair bill, and/or appraisal
of the condition of the vehicle.
Claims a full refund of the Connecticut use tax because the
person can prove the original purchase was exempt.
You must complete CERT-106 in its entirety and submit the
supporting documentation listed above. Submit clear, legible
The general sales and use tax rate is 6.35%.
copies of the original documents only. DRS will not return original
The tax on the sale of most motor vehicles for more than $50,000
documents.
is 7.75%. A
motor vehicle subject to this tax rate does not include:
Notice of Allowance or Disallowance of a Claim: DRS generally
A motor vehicle subject to the 4.5% tax rate for vehicles
gives notice that a claim for refund was allowed or disallowed within
purchased by members of the armed forces on full-time active
90 days of receiving a properly completed CERT-106. Allowed claims
duty who are not residents of Connecticut or their spouses;
are subject to further examination as provided by law.
A motor vehicle having a gross vehicle weight rating of 12,500
For More Information: Call 1-800-382-9463 (Connecticut calls
pounds or less that is not used for private passenger purposes,
outside the Greater Hartford calling area only) or 860-297-5962 (from
but is designed or used to transport merchandise, freight or
anywhere). TTY, TDD, and Text Telephone users only may transmit
persons in connection with any business enterprise and issued
inquiries anytime by calling 860-297-4911. Visit the DRS website at
a commercial registration or more specifi c type of registration
www.ct.gov/DRS to preview and download forms and publications.
by DMV; or
A motor vehicle having a gross vehicle weight rating over 12,500
pounds.
Part II - Purchaser: Read the instructions fi rst, then complete Parts II, III, and IV. Please print clearly.
Name of purchaser
Last
First
Social Security Number
Address
City
State
ZIP code
Name of purchaser (If co-ownership)
Last
First
Social Security Number
Address
City
State
ZIP code
Part III - Motor Vehicle Identifi cation and Refund Calculation
Description of Motor Vehicle
Date of purchase
Date of registration
Make of vehicle
Model
Year
Vehicle Identifi cation Number
Odometer reading on date of purchase
Refund Calculation
Tax Rate Table - Enter the applicable tax rate for your purchase in Line 2.
4.5%
(.045) Qualifying active duty nonresident member of the military or their
Multiply the applicable tax rate from the Tax Rate Table by the actual
spouse regardless of purchase date;
purchase price. Subtract this amount from the tax paid to DMV.
6.35% (.0635) Date of purchase is on or after July 1, 2011, and the purchase price
is equal to or less than $50,000 before trade-in;
Value used by DMV to compute tax
7%
(.07) Date of purchase is on or after July 1, 2011, and on or before
June 30, 2015, and the purchase price is more than $50,000
before trade-in; or
00
1. Actual purchase price ..................
7.75% (.0775) Date of purchase is on or after July 1, 2015, and the purchase
price is more than $50,000 before trade-in.
.
2. Enter tax rate from table above ....
3. Actual use tax: Multiply Line 1 by Line 2. ................................................................................................
00
00
4. Tax paid to DMV ......................................................................................................................................
00
5. Refund claimed: Subtract Line 3 from Line 4. .........................................................................................
Part IV - Purchaser’s Declaration
I, the purchaser named in Part II, declare that I purchased the motor vehicle identifi ed in Part III from the seller named in Part V. The
actual purchase price of the vehicle was $
. No other consideration, such as transfers of property other
____________________________
than money or cancellations or offsets of debts owed by the seller, has been or will be paid or transferred by me in connection with my
purchase of the vehicle identifi ed in Part III. I declare under the penalty of law that I have examined this certifi cate and to the best of my
knowledge and belief it is true, complete, and correct. I understand the penalty for willfully delivering a false return to DRS is a fi ne of not
more than $5,000, imprisonment of not more than fi ve years, or both.
Purchaser’s signature
Purchaser’s name (print)
Date
Telephone number
(
)
If co-ownership, check the appropriate box and enter the information below:
And (common)
Or (joint)
Other purchaser’s signature
Other purchaser’s name (print)
Date
Telephone number
(
)
Part V - Seller’s Declaration
I, the seller, declare that I sold the vehicle identifi ed in Part III to the purchaser named in Part II. The actual purchase price of the vehicle
was $
. No other consideration, such as transfers of property other than money or cancellations or offsets
____________________________
of debts owed to the purchaser, has been or will be paid or transferred to me in connection with my sale of the vehicle identifi ed in Part III.
I declare under the penalty of law that I have examined this certifi cate and to the best of my knowledge and belief it is true, complete, and
correct. I understand the penalty for willfully delivering a false return to DRS is a fi ne of not more than $5,000, imprisonment of not more
than fi ve years, or both.
Seller’s signature
Seller’s name (print)
Date
Telephone number
(
)
Seller’s address
Other seller’s signature
Other seller’s name (print)
Date
Telephone number
(
)
Other seller’s address
(Rev. 11/16)
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